KIDS SUMMER BOOT CAMPS

KIDS SUMMER
BOOT CAMPS
Financial Assistance
is available!
Bring your kids for a great 1 hour cardiovascular and agility
workout on land or in the water or do both! Please make sure to
bring your water bottles and towels to both classes, water shoes
to the H20 boot camp!
5 Week Session:
Starting July 23rd to August 22nd
9am to 10am
Ages: 9 to 13
Mondays—BOOT CAMP— (Murphy Park Track) —$30/$50
Or
Wednesdays—H20 BOOT CAMP - (Murphy Park Pool) —$30/$50
Or
Both Days — BOOT CAMP and H20 BOOT CAMP—$50/$70
For more information please call the Taylor
Family YMCA @ 512-365-9622!

Check Session:
2012 Program
Registration Form
Kids Summer Boot Camps
For Single Class: $30 YMCA Member / $50 Non-YMCA Member
For Both Classes: $50 YMCA Member / $70 Non-YMCA Member
Class Time:
July 23—August 22
9am—10am
______ Mondays-Boot Camp- (Murphy Park Track) - CCC Code 12FIT
Or
______ Wednesdays-H20 Boot Camp-(Murphy Park Pool) - CCC Code 12FIT
Or
______ Both Days-CCC Code-12FIT
PARTICIPANT NAME_______________________________________________________________ SEX (M) or (F)
AGE__________________
EMAIL ADDRESS___________________________________________________________________________________________________________
ADDRESS____________________________________________________________________
BIRTHDATE_________/___________/___________
CITY_____________________________STATE_________________ZIP__________________ HOME PHONE (__ __)____________________
PARENT/ GUARDIAN NAME_____________________________________________________
WORK PHONE (___ _)____________________
CELL PHONE (_____)______________________
PERMISSION FOR TRANSPORTATON: The YMCA Staff has my permission to transport my child to and from program location in the event of an
emergency. I understand reasonable precautions will be taken to ensure the safety and supervision of my child.
MEDICAL WAIVER: In the event that my child requires emergency medical treatment and I cannot be reached, I hereby authorize the YMCA Staff
to make arrangements to transport my child to the nearest hospital/emergency medical facility. I give my consent for any and all necessary medical
treatment, if, in fact my child requires the attention of a physician.
WAVIER: I understand that YMCA activities have inherent risks and I hereby assume all risks and hazards incident to my participation in all
YMCA activities including transportation to and from said activities. I further waive, release, absolve, indemnify, and agree to hold harmless
the YMCA, the organizers, volunteers, supervisors, officers, directors, participants, coaches, referees as well as persons or parents transporting
participants to or from such activities from any claims or injury sustained during my use of YMCA facilities or participation in any
YMCA activity whether located on YMCA property or not.
PHOTO RELEASE: I give my consent for pictures taken of my child involved in YMCA programs to be used for future YMCA promotions or display.
REFUND/TRANSFER POLICY: Transfer or change requests are at the discretion of the Program Coordinator upon availability. There may be a
transfer fee of $15.00.
PARENT/GUARDIAN ACKNOWLEDGEMENT: This is to acknowledge that I have read and agree to the above information. Int.___________
________________________________________________________________
Parent Signature
______________________
Date
Office Use Only: Amount paid _______ Date _______ Staff initials______